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TCS EMPLOYMENT APPLICATION FORM

BASIC DETAILS
Reference #

CT20141345457

PERSONAL DETAILS
College/Institute

Truba Inst. of Engg. & Information Tech

Name

Mr. Pratik Mudliar

Mother's Maiden Name

Pramodini Mudliar

Father's Name

Mr.Mukesh Mudliar

Date Of Birth

27/04/1994

Nationality

India

Gender

Male

Area Of Interest

IT Application Development And


Maintainance,Engineering and Industrial
Services,IT Infrastructure Services,Research

CONTACT DETAILS
PERMANENT ADDRESS
House No./Apartment Name/Block No

G-95/10,Tulsinagar

Road/Street/Lane
Area/Landmark

1250 J.P Hospital

City

Bhopal

State

Madhya Pradesh

PIN Code

462003

Country

India

PRESENT ADDRESS
House No./Apartment Name/Block No

G-95/10,Tulsinagar

Road/Street/Lane
Area/Landmark

1250 J.P Hospital

City

Bhopal

State

Madhya Pradesh

PIN Code

462003

Country

India

ACADEMIC DETAILS:
Degree

Graduate

Course

Duration

Duration

Course

Name

From

To

Type

Bachelor

01/06/2012 01/06/2016 Full Time

Of

University/Institute

Board Of

Specialization CGPA/Marks Total

Education
Truba Inst. Of Engg. &

Electronics &

Information Tech

Communicatio

Engineerin

Percentage

Obtained

Marks/CGPA

6.04

10.0

60.4

428.0

500.0

85.6

508.0

600.0

84.66

g
XII

07/03/2011 07/03/2012 Full Time

Scholars Home Public State Board

Pcm

School
X

01/03/2009 01/03/2010 Full Time

Scholars Home Public State Board


School

Are there any break in studies ?

No

Rewards Or Scholarships :

No

Academic Projects Undertaken:

No

Have you done any other course ?

No

Do you have any pending backlogs


currently ?

No

Declaration
1.

You have taken all subject marks into consideration for calculating the obtained/Total Marks/CGPA in each
of the above mentioned academic qualifications :
Yes

2.

The "Marks/CGPA Obtained" entered by you for each of the above mentioned academic qualifications has
been secured in the first attempt :
Yes

3.

You have considered only the Marks/CGPA obtained during the normal duration of the course for calculating
Obtained/Total Marks/CGPA :
Yes

4.

You have completed each of the above mentioned academic courses in the stipulated time as specified by
your University/Institute and as per TCSL selection guidelines and do not have any extended education:
Yes

5.

You have declared break in studies/work experience and pending backlogs,if any, during your academics:
Yes

6.

You have not attended the TCSL Selection Process in the last 6 months:
No

7.

You have read the TCSL eligibility criteria and understand that your candidature/application/offer/ on
boarding is subject to fulfillment of the specified criteria :
Yes

I Mr. Pratik Mudliar solemnly declare that the information in this form is truly stated and correct and I am competent to
furnish as well as verify it with adequate details whenever requested for by TCSL.

CONTACT DETAILS
E-mail ID

pratik.mudliar1@gmail.com

Telephone(R)

2559411

Alternate E-Mail ID

papachep@gmail.com

Telephone(M)

8962828670

LANGUAGE DETAILS:
Language

Mother Tongue

Read

Speak

Write

Hindi

Yes

Yes

Yes

Yes

English

No

Yes

Yes

Yes

Tamil

No

No

Yes

No

CERTIFICATION DETAIL:
Certification Name
CCNA Service Provider Certification

TCS RELATED DETAILS:


Have you appeared for TCS Test / Interviews earlier? Yes, Yes, I have appeared in the closed campus TCS Drive on
8/10/2015 at Truba Institute of Engineering and Information Technology as a fresher. Did not get selected.

Security Details
Are you involved in any pending and / or closed Civil / Criminal / case / proceedings / charges / enquiry prior to joining

No

TCS.
Are you involved in any pending and / or closed Disciplinary / malpractices and / or any other charges / proceedings /
enquiry / case pending against me in any University or any other educational authority / institution prior to joining TCS.

''If the answer to any of the above mentioned question is YES give full particulars of the case / arrest /detention / fine
/conviction / sentence / punishment etc. and / or the nature of the case pending in the Court / University / Educational
authority etc. at the time of filling this form.''

No

TCS Terms and Conditions


In connection with my application to render services to Tata Consultancy Services Ltd (the "Company"), I hereby agree as
follows:I certify that the information furnished in this form as well as in all other forms filled-in by me in conjunction with my
traineeship is factually correct and subject to verification by TCS including Reference Check and Background Verification. I
accept that an appointment given to me on this basis can be revoked and/ or terminated without any notice at any time in
future if any information has been found to be false, misleading, deliberately omitted/suppressed. As a condition of
Company's consideration of my application for traineeship with the Company, I hereby give my consent to the Company to
investigate or cause to be investigated through any third parties my personal, educational and pre or post joining history. I
understand that the background investigation will include, but not be limited to, verification of all information given by me to
the Company. I confirm that the Company is entitled to share such investigation report with its clients to the extent necessary
in connection with the Services, which I may be required to provide to such clients. I confirm and undertake that the
Company shall incur no liability or obligation of any nature whatsoever resulting from such investigation or sharing of the
investigation results as above. I certify that I am at present in sound mental and physical condition to undertake employment
with TCS. I also declare that there is no criminal case filed against me or pending against me in any Court of law in India or
abroad and no restrictions are placed on my travelling anywhere in India or abroad for the purpose of business of the
Company.

Your Electronic Signature is:

Name:Mr. Pratik Mudliar

Date:07/02/2016

Place:Bhopal

TCS is an equal opportunity employer that aims to integrate global diversity and inclusion at each level within our
organization. Hiring decisions are solely made on the capability of an individual to perform a role. Any personal details like
gender, age and nationality that may be provided by you during the course of application or selection process will be used for
administrative records and all qualified applicants will receive consideration for employment without regard to this
information.